Active NPI
McIntyre Counseling, LLC
- Clinical Social Worker
- Enfield, CT
National Provider Identifier
1629085394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 005433
- Legal business name
- MCINTYRE COUNSELING, LLC
- Practice address
- 4 Katherine Rd
Enfield, CT 06082-2514 - Phone
- (860) 253-0069
- Fax
- (860) 253-0079
- NPI assigned
- Aug 2, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Denise Bradfield, LCSW
- Title
- Owner
- Phone
- (860) 253-0069
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 005433 | CT | Primary |
Addresses
Primary practice location
4 Katherine Rd
Enfield, CT 06082-2514
Mailing address
4 Katherine Rd
Enfield, CT 06082-2514
Phone (860) 253-0069
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004249092 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
115 Elm St
Ste 103
Enfield, CT 06082
Phone (860) 253-0069
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Enfield, CT
- NPI 1710179098
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1676246400000",
"number": "1629085394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 KATHERINE RD",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060822514",
"telephone_number": "860-253-0069",
"fax_number": "860-253-0079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 KATHERINE RD",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060822514",
"telephone_number": "860-253-0069",
"fax_number": "860-253-0079"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MCINTYRE COUNSELING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-02",
"last_updated": "2023-02-13",
"certification_date": "2022-08-15",
"status": "A",
"authorized_official_last_name": "BRADFIELD",
"authorized_official_first_name": "DENISE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "860-253-0069",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "005433",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004249092",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Enfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.